Brown A S, Cohen P, Harkavy-Friedman J, Babulas V, Malaspina D, Gorman J M, Susser E S
Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, New York 10032, USA.
Biol Psychiatry. 2001 Mar 15;49(6):473-86. doi: 10.1016/s0006-3223(01)01068-x.
Premorbid neurocognitive, neuromotor, and behavioral function tends to be disturbed in schizophrenia. We previously demonstrated that a birth cohort clinically and serologically documented with prenatal rubella evidenced a marked increase in risk of nonaffective psychosis. In our study, we examined whether rubella-exposed subjects destined to develop schizophrenia and other schizophrenia spectrum disorders (SSD), compared with exposed control subjects, had greater impairment in several premorbid functions.
Subjects were interviewed using a direct, comprehensive research assessment and diagnosed by consensus. We compared the degree of IQ decline, as well as premorbid neuromotor and behavioral dysfunction, between rubella-exposed subjects who developed schizophrenia spectrum psychosis (SSP) and exposed control subjects from the cohort. We also compared the gestational timing of rubella infection between the cases and control subjects.
This rubella-exposed birth cohort evidenced a markedly increased risk of SSD (20.4% or 11/53). Rubella-exposed SSP cases, compared with rubella-exposed control subjects, demonstrated a decline in IQ from childhood to adolescence, and increased premorbid neuromotor and behavioral abnormalities. Moreover, it appears that early gestational rubella exposure may represent a period of increased vulnerability for SSD.
These findings link a known prenatal exposure, a deviant neurodevelopmental trajectory in childhood and adolescence, and SSP in adulthood within the same individuals.
精神分裂症患者病前的神经认知、神经运动和行为功能往往会受到干扰。我们之前证明，一个有产前风疹临床和血清学记录的出生队列显示非情感性精神病风险显著增加。在我们的研究中，我们调查了与暴露的对照受试者相比，注定要患精神分裂症和其他精神分裂症谱系障碍（SSD）的风疹暴露受试者在几种病前功能上是否有更严重的损害。
使用直接、全面的研究评估对受试者进行访谈，并通过共识进行诊断。我们比较了患精神分裂症谱系精神病（SSP）的风疹暴露受试者与队列中暴露的对照受试者之间智商下降的程度以及病前神经运动和行为功能障碍的情况。我们还比较了病例组和对照组风疹感染的妊娠时间。
这个风疹暴露的出生队列显示SSD风险显著增加（20.4%或11/53）。与风疹暴露的对照受试者相比，风疹暴露的SSP病例从儿童期到青春期智商下降，病前神经运动和行为异常增加。此外，似乎妊娠早期风疹暴露可能代表SSD易感性增加的时期。
这些发现将已知的产前暴露、儿童期和青春期异常的神经发育轨迹以及成年期的SSP联系在同一个体中。
